Breast Cancer
A 45-year-old woman presents to her primary care physician for a general check up. She has not seen a primary care physician for the past 20 years but states she has been healthy during this time frame. She had breast implants placed when she was 29-years-old (which have been stable and without issue) but otherwise has not had any surgeries. She denies any family history of breast cancer. She is concerned about her risk for breast cancer given her friend was recently diagnosed. Her temperature is 97.0°F (36.1°C), blood pressure is 114/64 mmHg, pulse is 70/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is unremarkable. Which of the following is the most appropriate workup for breast cancer for this patient?
No intervention needed at this point
BRCA genetic testing
Mammography
Sentinel node biopsy
Ultrasound
A 35-year-old woman is presenting for a general wellness checkup. She is generally healthy and has no complaints. The patient does not smoke, drinks 1 alcoholic drink per day, and exercises 1 day per week. She recently had silicone breast implants placed 1 month ago. Her family history is notable for a heart attack in her mother and father at the age of 71 and 55 respectively. Her father had colon cancer at the age of 70. Her temperature is 99.0°F (37.2°C), blood pressure is 121/81 mmHg, pulse is 77/min, respirations are 14/min, and oxygen saturation is 98% on room air. Physical exam is unremarkable. Which of the following is the most appropriate initial step in management?
Mammography age 50
Mammography now
Ultrasound
Colposcopy
A 27-year-old woman presents to her primary care doctor with concern about a mass she felt in her left breast on a recent breast self-examination. She denies any nipple discharge and reports that her grandmother died of breast cancer at the age of 70. She is otherwise healthy, has a 5 pack-year smoking history, and drinks 3 to 4 alcoholic beverages daily. Her temperature is 99.0°F (37.2°C), blood pressure is 120/84 mmHg, pulse is 70/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical examination confirms the presence of a firm lump in the superolateral quadrant of the left breast. There are no evident overlying skin changes and there is no notable axillary lymphadenopathy on palpation. An ultrasound is performed as seen in Figure A. Which of the following is the most appropriate next step in management?
Excision biopsy
Fine needle aspirate biopsy
Mammography
Genetic testing
Surgical excision
A 52-year-old female was found upon mammography to have branching calcifications in the right lower breast. Physical exam revealed a palpable nodularity in the same location. A tissue biopsy was taken from the lesion, and the pathology report diagnosed the lesion as comedocarcinoma. Which of the following histological findings is most likely present in the lesion?
Pleomorphic cells surrounding areas of caseous necrosis
Disordered glandular cells invading the ductal basement membrane
Extensive lymphocytic infiltrate
Halo cells in epidermal tissue
Orderly rows of cells surrounding lobules
A 27-year-old female has a 14 x 12 x 9-cm mass in her left breast. It has been present for seven years and has slowly grown to its present size. Her grandmother has breast cancer and her father has prostate cancer. Physical examination shows that the mass is firm, nontender, rubbery and completely movable, and it is not attached to the overlying skin or the chest wall. There are no palpable axillary nodes or skin ulceration. Which of the following is the most likely diagnosis?
Cystosarcoma phyllodes
Inflammatory breast cancer
Intraductal papilloma
Chronic cystic mastitis
Mammary ductal ectasia
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